Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy.
OBJECTIVE: To propose a standard for the conduct of visually directed transrectal high-intensity focused ultrasound (HIFU) and to offer a formal description of the changes observed on B-mode ultrasonography (US) during this procedure. We describe our early experience of using two different treatmen...
| Main Authors: | , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2006
|
| _version_ | 1826290367487541248 |
|---|---|
| author | Illing, R Leslie, T Kennedy, J Calleary, J Ogden, C Emberton, M |
| author_facet | Illing, R Leslie, T Kennedy, J Calleary, J Ogden, C Emberton, M |
| author_sort | Illing, R |
| collection | OXFORD |
| description | OBJECTIVE: To propose a standard for the conduct of visually directed transrectal high-intensity focused ultrasound (HIFU) and to offer a formal description of the changes observed on B-mode ultrasonography (US) during this procedure. We describe our early experience of using two different treatment methods; algorithm-based HIFU and visually directed HIFU for the treatment of organ-confined prostate cancer. PATIENTS AND METHODS: Between November 2004 and October 2005, 34 men were treated using the Sonablate-500 (Focus Surgery, Indianapolis, IN, USA) as primary therapy for T1 or T2 prostate cancer. None had had previous hormone therapy and all had > or = 3-month PSA nadirs recorded at the follow-up. Nine men were treated using an algorithm-based protocol (group 1) and 25 using visually directed therapy (group 2). The conduct of visually directed treatment was described and changes seen using B-mode US were categorized using three 'Uchida' grades. RESULTS The mean PSA nadir achieved in group 2 was 0.15 ng/mL, vs 1.51 ng/mL in group 1 (P < 0.005). In group 2, 21 of 25 men achieved PSA nadirs of < or = 0.2 ng/mL 3 months after treatment. Seven men achieved undetectable PSA values. The occurrence rate of treatment-related toxicity was similar in both groups. CONCLUSION: Visually directed, transrectal HIFU enables clinically important and statistically significantly lower PSA nadirs to be achieved than algorithm-based HIFU. This is the first reported experience of visually directed HIFU for the treatment of organ-confined prostate cancer. We think that this is the first attempt to standardize the conduct of therapy; such standardization facilitates teaching it, and makes it possible to derive quality standards. The standardization of the conduct of therapy is a key step in the process of health technology assessment. |
| first_indexed | 2024-03-07T02:43:07Z |
| format | Journal article |
| id | oxford-uuid:ab217a62-57e8-4b1d-a7bc-1aad9a3e6a65 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:43:07Z |
| publishDate | 2006 |
| record_format | dspace |
| spelling | oxford-uuid:ab217a62-57e8-4b1d-a7bc-1aad9a3e6a652022-03-27T03:19:47ZVisually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ab217a62-57e8-4b1d-a7bc-1aad9a3e6a65EnglishSymplectic Elements at Oxford2006Illing, RLeslie, TKennedy, JCalleary, JOgden, CEmberton, M OBJECTIVE: To propose a standard for the conduct of visually directed transrectal high-intensity focused ultrasound (HIFU) and to offer a formal description of the changes observed on B-mode ultrasonography (US) during this procedure. We describe our early experience of using two different treatment methods; algorithm-based HIFU and visually directed HIFU for the treatment of organ-confined prostate cancer. PATIENTS AND METHODS: Between November 2004 and October 2005, 34 men were treated using the Sonablate-500 (Focus Surgery, Indianapolis, IN, USA) as primary therapy for T1 or T2 prostate cancer. None had had previous hormone therapy and all had > or = 3-month PSA nadirs recorded at the follow-up. Nine men were treated using an algorithm-based protocol (group 1) and 25 using visually directed therapy (group 2). The conduct of visually directed treatment was described and changes seen using B-mode US were categorized using three 'Uchida' grades. RESULTS The mean PSA nadir achieved in group 2 was 0.15 ng/mL, vs 1.51 ng/mL in group 1 (P < 0.005). In group 2, 21 of 25 men achieved PSA nadirs of < or = 0.2 ng/mL 3 months after treatment. Seven men achieved undetectable PSA values. The occurrence rate of treatment-related toxicity was similar in both groups. CONCLUSION: Visually directed, transrectal HIFU enables clinically important and statistically significantly lower PSA nadirs to be achieved than algorithm-based HIFU. This is the first reported experience of visually directed HIFU for the treatment of organ-confined prostate cancer. We think that this is the first attempt to standardize the conduct of therapy; such standardization facilitates teaching it, and makes it possible to derive quality standards. The standardization of the conduct of therapy is a key step in the process of health technology assessment. |
| spellingShingle | Illing, R Leslie, T Kennedy, J Calleary, J Ogden, C Emberton, M Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title | Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title_full | Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title_fullStr | Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title_full_unstemmed | Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title_short | Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy. |
| title_sort | visually directed high intensity focused ultrasound for organ confined prostate cancer a proposed standard for the conduct of therapy |
| work_keys_str_mv | AT illingr visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy AT lesliet visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy AT kennedyj visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy AT callearyj visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy AT ogdenc visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy AT embertonm visuallydirectedhighintensityfocusedultrasoundfororganconfinedprostatecanceraproposedstandardfortheconductoftherapy |